Birth experiences with Kaiser in CA?

December 19, 2017 8:50 AM

I'm looking for experiences from others who have had their babies with Kaiser in CA, specifically the Women and Children's Center in Roseville. On paper, the center looks great. Their website describes an "empowered birth experience...family centered...healing environment" which all sound exactly like what I'm looking for. Of course I will do the tour in the third trimester, but I'd like to hear from others who have had positive (or not) experiences with them.

Home birth is not an option. Doula may or may not be a possibility. So far, pregnancy is going well with no complications and only advanced maternal age being a factor.

I'd like as little medical intervention as possible. Meaning - epidural is a last resort, and so is a C-section unless it's an emergency. I plan on having a natural birth. Achieving this, for me, means not being confined to a bed hooked up to monitors and being able to relax and move around as much as possible. Birthing ball, birthing tub, eat a small snack or drink if I feel like I need it... having the freedom to adjust the lighting if I need to. Things like that.

Am I in la-la land, or are these things possible? All I know about birth is what I've seen in the movies (yikes!), and I want a different experience. I'm afraid that my desire for a natural, calm, sane birth will be railroaded by pushy doctors who want to induce or perform a C-Section because I'm not progressing quickly enough.

I've heard good things about Roseville, but I'm a little on the "woo" side and I feel strongly about having a calm, meditative environment. I'm just not sure if this is realistic and I'd love to hear from people who have given birth there (or a birthing center in general). Did they respect your birth plan? What should I know? How can I best prepare?

If it's not obvious, this is our first baby : )

Thank you!

posted by anonymous to Health & Fitness (11 answers total)

I haven't been to this specific birthing center, but I do think you should just go ahead and do the tour now if you are worried about it! I did my hospital tour in the second trimester just because I wanted to get a sense of the place (I am also on Kaiser, and there is only one main option covered by Kaiser in my area, so I knew if I really didn't like it I would need some time to figure something else out or come to terms with it -- luckily I love our hospital so it was not an issue!). I think being able to see the center and talk to people who work there will give you a much better sense of things. You can also get specific numbers on inductions, C-sections, what they have available in terms of non-medication comfort techniques, etc. I would also recommend doing your childbirth classes through the birthing center if they offer them -- again, we did ours through our hospital, and it added a lot of peace of mind that the teacher could give stats on the lower C-section rate, baby friendly practices, etc. that were specific to our hospital.

Also - talk to your OB and figure out how they do things with Kaiser at this specific location. I was initially super stressed because -- at least where I am at -- you do not have your specific OB for the birth if your insurance is Kaiser. You just get whoever is on-call for Kaiser when you go into labor. But, after talking to my doctor and others who have given birth on Kaiser, I was actually really reassured. They have a standard birth plan form that allows you to specify things like your preferences for pain medication, comfort techniques, etc. and it seems like people's experience is that this is well respected. My OB is really supportive of my plan to try for a natural birth if at all possible and I feel confident that this will be respected (even if you can't 100% predict how labor will go). Also be sure to ask how far they will let you go past your due date due to your age -- my doc has agreed I can go two weeks past assuming no other complications, but a friend of mine who is in her early 40s was told she needed to be induced at her due date because of her age. So, get a sense of this now so that it is not a surprise.

Finally, if you can in any way swing it, DOULA! My husband is amazing and wonderful and will be there for the birth, but he is also going through this for the first time in his life! Having someone there who has been through this many times and can advocate for me during a vulnerable time is so reassuring. I realize it is a big expense, BUT if you have FSA funds they can be used for doula services. And, to me, it is really worth it because doing everything possible for a positive birth experience is important to me. Our doula has made me confident that even if things don't go totally as planned, I will know I did everything I could to avoid a C-section, etc. rather than just getting pressured into it. I have had some negative health experiences in the past by feeling really pressured by medical professionals to do things that I think did not turn out to the best thing for me. Regardless of what happens with my birth, I obviously don't want to have that feeling again. Having someone in the room who can be a strong advocate for me makes me feel a lot more confident that if we do need to take various medical interventions, it will be because there was truly a medical need for that to happen.
posted by rainbowbrite at 9:48 AM on December 19, 2017

eat a small snack or drink if I feel like I need it

Not in CA, but most places I've heard about will let you have drinks, though they'll keep an eye on how much because contractions can result in vomiting.

I've never heard of a place that will let you eat a snack, because of the risk of aspiration if you end up needing a general anesthesia for a C-section -- which you've mentioned not wanting, but if things go seriously, seriously south, it's what happens.
posted by joyceanmachine at 11:06 AM on December 19, 2017

I've never heard of a place that will let you eat a snack

Our hospital will let you eat light snacks at the doctor's discretion, so I think this may not be the general rule anymore. I assume if labor seemed to be going downhill, they would cut you off.
posted by rainbowbrite at 11:10 AM on December 19, 2017

Seconding get a doula. A doula will be there to help you advocate for the kind of childbirth experience you want. Ask your ob and any friends with young kids for doula recommendations. Assuming you have a husband, no matter how wonderful he is he has never given birth. I still remember giving birth almost 45 years ago and my husband telling me to breathe and me telling him to go *&%(&^%. Having an experienced woman with you the whole time is a huge help. If you can't get a doula then a close friend or relative who has had a natural childbirth would be helpful.
posted by mareli at 11:39 AM on December 19, 2017

So this topic is related to my professional work and I can tell you that while I don't know this particular facility, California in general is a leader in reducing unnecessary c-sections (that's the general trend in the field but CA is the best at it at a state level). Pushy doctors who want to do c-sections for their convenience are a thing, BUT the people who actually know shit about quality of care in this field are against it and that's considered old school. You want to look at facility's c-section rate - this is public information. If you can't find it on their website, try searching for The Joint Commission or Leapfrog's public reporting on c-section rates. This is really the info you want. Look for rates below 24%. Above that is higher than the goal rate, lower is good. If you're seeing something like 30-40%, either they have a very, very high risk population or they are doing something wrong. Also, there's new research showing that labor takes longer than they used to think, so you may want to look into that to have a sense of what you can push for (ha, pun unintended!). Also, yeah, they are leaning towards allowing small snacks in labor now - crackers, jello, etc, not a cheeseburger! - no food is another older rule falling out of fashion. I think doing general for a c-section is pretty rare. Another thing to check, not all facilities have birthing tubs, that's a question to ask (or it should be on their website).

Do you have a midwife, or an OB? Midwives are less likely to push c-sections. Doulas are great, and research demonstrates better outcomes/lower c-section rates if you have one, definitely get one if you can swing it. Meet with a bunch to find one you like!

Your desire for a calm environment is very reasonable and should be respected unless you develop a very serious complication. You should definitely discuss them with your provider, wanting to talk about this with them isn't weird or a burden at all. IIRC, they usually start talking about birthing stuff around 20 weeks or so.
posted by john_snow at 12:12 PM on December 19, 2017 [4 favorites]

I wish I had had a doula. The doctors were great, but I barely saw them, and, despite the hospital's claims, I spent the entire time stressed to hell dealing with battleaxe nurses whose information was from 1952. I brought a cooler of food and drink and told them to (at that point) go to hell. Keep in mind that they are hospitals/birthing centres, not prisons -- you are free to do as you please, within reason, up to and including booking it mid-labour to another place to give birth.

It would have relieved a LOT of stress if I had had someone with either a serious don't-fuck-with-me attitude that was not me, or someone skilled at shooing away "helpful" nurses. That I was stuck being the one constantly demanding they call my OB whenever they came up with a new fantasy rule about how I shouldn't do X because they didn't in 1964 or whatever was not at all pleasant and a trained, skilled, go-between to fend off idiots and remind them of the birth plan would have been terrific.
posted by kmennie at 3:09 PM on December 19, 2017 [1 favorite]

Get a doula, even if that's a friend with no formal training-someone who's attended multiple births and can be your advocate.

The doctors/nurses are there to make a healthy baby. The doula is there to make your experience better.

I had two hospital births in northern CA, the most recent almost 20 years ago. First was with an OB/GYN doctor and had nuisances; second was with a nurse-midwife and much better. I had a doula for the second. For the first, I had a partner who thought that the doctors know best, and he failed to stop them from giving me a catheter. (It hurt for days; I remember the catheter pain more than the pain of actually pushing out the baby.)

For both, I walked around a lot; couldn't tolerate sitting down. Shook off all attempts to do invasive monitoring. For the second, I shrugged past the phlebotomist - I wouldn't let them draw blood. (Husband tells me I snarled at the guy until he backed off. I don't remember that part; I remember that it hurt too much to hold still enough for a needle.) I alternated between "too hot" and walking around pretty much naked, and "too cold" and needing heated blankets. Also at one point in the first, one of the nurses tried to get me to be more quiet - apparently I was loud enough to bother people. Fuck them. I was giving birth; if they wanted quiet, they could close the door. (There were curtains but the door was open to let nurse-people come in and out.)

Figure out what helps you to relax when you're stressed, in pain, and worried. Some of the plans will be meaningless - you can't know, now, what will be comfortable and what won't. Maybe you'll want music; maybe you'll find it too distracting. Maybe you'll want to walk. Maybe you'll want to lie down. Maybe you'll want your back massaged. Maybe you won't want to be touched.

Prepare yourself, in advance, to carry a firm attitude of "my comfort is TOP PRIORITY unless someone is insisting that the baby's health absolutely requires something different."

If someone says, "wouldn't you rather..." or "I think you should..." give it about 2 seconds of contemplation, and go with your gut reaction, yes or no. You are not there to make their job easier or more comfortable.

If you want calm, meditative, and a bit on the "woo" side, definitely talk to them in advance. Ask what they think of meditation, of chanting during a birth, of alternative spiritual practices. You're not looking for specific answers, but a general tone - asking will let you know if it's "whatever you want that's not getting in the way of medical needs is great" or "we want no disruptions to our normal procedures," which is a warning sign.
posted by ErisLordFreedom at 4:51 PM on December 19, 2017

If you can make it a priority to swing getting a doula, it's really fantastic, especially if you're having your first and you want to go natural. Having someone who is just there for you and has a ton of experience helping women through birth is a tremendous source of support and goes a long way to making you feel calm and secure through it all.
posted by quince at 5:36 PM on December 19, 2017

As to that actual hospital, I don't know. But there can be wide variations even within the Kaiser system. My son and daughter in law had their their prenatal care at one Kaiser. Late in the third trimester they had several negative encounters with staff when they went for stress tests. The hospital tour was perfunctory and the nurse conducting it didn't answer questions well, was pretty dismissive. Things piled up and they ended up switching over to the Kaiser close to where her mother lived. They had impulsively taken a tour there at some point and liked the tone a lot bettter. People ther were much more tuned in to their wishes, didn't give perfunctory answers, etc, and overall they had a better experience. She ended up with a c-section with that baby and with her second one 3 years later at another hospital. But overall I think theY were heard and considered a lot better at their second Kaiser than at the first one.
posted by SLC Mom at 11:13 PM on December 19, 2017

I'm in Los Angeles and have had a couple of kids in the last few years. My first advice to you would be to join some local mom's FB groups, go to prenatal yoga classes (for networking, in addition to the class itself) and talk to some doulas in your area, even if you don't hire them. They know what's up. For example, I couldn't get my awful OB to recommend a doula he'd worked with, so I started calling around. None of the doulas in my area would work with him. They wouldn't say it outright, they sort of danced around it, but after talking to five or six people I got the point and changed doctors. As far as I've heard the Kaiser in our area is very good and hits the points you are concerned about, but the local mom's and local doulas will have better info.

Most of your concerns I also wrote into my birth plan and then discussed with my new doctor maybe 5-6 weeks before my due date. She explained to me what she would be looking for that would cause her to recommend an epidural or a csec or other interventions. Understanding her pov made a huge difference for me when in the hospital those things were recommended. We didn't have to have any emotional back and forth because we both knew where each other was coming from.
posted by vignettist at 4:15 PM on December 20, 2017

I've been to about 75 births at home, in hospitals, and in birth centers. Also, I had my own birth. I've been to a couple births at Kaiser facilities although not Roseville.

Here's my very brief advice: Roseville has CNMs - working with a nurse midwife will get you closer to your goals. I'm not sure what one has to do to get a midwife there, besides the random luck of having an uncomplicated birth. I would specifically request one.

But the number one thing you can do to get fewer interventions in any hospital birth is: go to the hospital as late as possible. Wait till your contractions are regular and frequent. If you can afford a doula, this will help, because that person will have the experience to advise you about whether you're early on or whether you should head to the hospital. You may be able to get someone who is still in a student stage and will charge less.

I was 1000% committed to a home birth with no drugs but when labor got really painful I was directing my homebirth midwives to take me in to the hospital for an epidural. I had my home birth, but only because it was too late to put me in a car at that point. Point being, if I had been in the hospital, as much as I was committed to no interventions, I would have asked for them in the moment. This is to say nothing of the pressure you get to get interventions by hospital staff. So in conclusion, if your goal is a peaceful enviroment with few interventions, stay home as long as you can and only go into the hospital when you're late in labor so you can just do mostly the birth part there.

Good luck, and remember, the birth is only one day long (give or take), parenting is a LIFETIME! Not to minimize the meaning of the birth experience, but whatever happens, it will be largely out of your direct control, and ultimately, you have decades to be the parent you want to become.
posted by latkes at 10:18 PM on December 20, 2017